8 Health Insurance Terms You Need To Know

Tuesday, September 1st, 2009

There are plenty of medical terms that govern health insurance that everyone has heard – yet they may not really know. Some terms are easy to understand, while others are downright odd. Before you start to read too much into your health insurance policy, there are some main medical and insurance terms that you need to be aware of. Here are 8 that you should know so you can properly understand your insurance:

Premium – for many people, this is what your employer, or sponsor, will pay each month for your health insurance. Sometimes, individuals pay this amount to their employer or directly to the health insurance company. This, in turn, covers you under their insurance.

Deductible: This is the amount that you have to pay from your own pocket before the insurance will take care of their part.

Copayment: This is the amount that you have to pay at the time of service (such as doctor visits, hospital stays, etc), that comes out of your pocket before your health insurance will pay the remainder. This is normally a small amount, usually under $50.

Coinsurance – many people have this, especially seniors that are on Medicare. This just means that you have one main health insurance plan and then another, smaller plan (coinsurance) that covers the remainder of the bill. Many people that are on fixed incomes have coinsurance so that they aren’t stuck with massive unexpected expenses.

Coverage Limits: There are some health insurance policies that will only pay for a specific set amount of different types of coverage. For example, they may only pay up to $1000 a year on basic physicals for your entire family. This is one area where you need to check your health insurance plan well so you aren’t caught with payments that you thought we covered.

In-Network – this is the term that is used to cover the doctors and other medical professionals that accept that specific health insurance. When you sign up for health insurance, you will normally get a book with a list of “in-network” providers that have already made an agreement with the health insurance company.

Prior Authorization – normally, health insurance companies will require that you have prior authorization either from them or from your primary care physician before you see a specialist. So, when you need to go to an OB/GYN or surgeon (or other specialized medical professional) you will need to check and see if you need to get a prior authorization to ensure that their services are covered.

Capitation: This is the overall amount that your health insurance company will pay to your medical professional (i. E. Doctor, surgeon, dentist) to ensure that they will see anyone covered under their health insurance plan.

While there are thousands of other health insurance terms that you should get to know, you should also take the time to read through your insurance plan so that you will be familiar with what is covered and what is not. There are so many different health insurance plans and different things that are covered and aren’t, so you need to be aware exactly what you have coverage for and what you might need in the future.

Dawn Enstruthe writes for website DS Health Insurance which info on topics like dental insurance for low income people and cheep dental insurance for seniors.

Health Insurance Plans For Seniors

Sunday, June 14th, 2009

Health insurance plans become increasingly necessary because of the increasing costs of medical care, hospitalization and medicine. The great majority of the affected by the lack of any form or medical care are the seniors, which is the population that is more vulnerable to health problems.

Nowadays, the role that health insurance plans play within the family economy is very important provided that they give reassurance when an unplanned event happens. In general, these plans are contracts by which the insured is reimbursed in case of illness or hospitalization.

There are some health insurance plans that could provide health coverage for people of old age in exchange for the payment of a fee every year. In order for seniors to be accepted as such by insurance companies, they need to be older 65 or whatever the national profile is. Some policies apply to people that are older than 70 or 75 years.

The criteria for a person to be approved by a health care provider should not be age but health condition. In this scenario, an insurance company will judge whether a person qualifies for a plan on the basis of their health not age. So for instance, if a person has heart condition and poor health, he or she would be likely to be rejected regardless of their age. Unfortunately, age determines how high or low the monthly payments for the health insurance plan will be.

Health insurance plans offer the insured the possibility of visiting highly qualified doctors that work in emergency rooms or clinics. Another benefit of these kinds of plans is that they compensate the insured with a fraction of the cost of the medical bill. Additionally, your health insurance plan could cover you whether you are in the country or not, when the time in the foreign country is not over the three months.

Among the other benefits that health insurance plans provide are: accidents, accidental death, organ loss, funerary costs, etc. When the reason of the death of the insured is due to covered illness or accident, the plan would also provide benefits to the dependents for a total of three years.

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What Is The Best Dental Insurance Plan For You

Thursday, June 11th, 2009

With constant increases in the cost of visiting the dentist, many people debate the decision of whether to buy dental insurance. Whether you are considering buying dental insurance through your employer or independently, be sure to investigate several different plans and ask questions which are detailed below. This information will help you choose the proper dental insurance plan for you before signing the contract of insurance.

All dental insurance plans have an annual maximum which is the ceiling of coverage that your insurance provides. It renews itself after each year of your insurance. The benefits that you have enjoyed during this year will not be sent to the following year. In short, you can only use those benefits once a year. The maximum coverage that most dental insurance give is a $1000 year. Policies may vary depending on the provider of the service, but generally dental insurance policies will only cover services of practitioners that are part of their network. Before you visit a clinic, make sure you understand the terms of the plan and what dentists you can visit, whether there is a network or if you may go to any. For your greater convenience, check the list of dentist in your neighborhood.

If you have discovered that your dental practitioner is not a member of the network covered by your dental insurance, find out whether your plan allows you visit a doctor outside the network. Unfortunately, when this is the case the coverage is not as good. The so-called the Customary and Reasonable Guide to Usual Fees is what most dental insurance companies use to determine the price of visit to the doctor. This means that the company will only reimburse on the basis of the fee they deem reasonable to pay regardless of how much your dentist really charged.

If your dental insurance plan allow you to continue visiting your current practitioner, he or she should not pay the difference. The dentist will expect to be paid from you, the full amount. They have an agreement with the insurance company where they are committed to charge you the difference. To avoid this from happening, make sure you find out what prices your insurance covers on that particular dentist you want to visit before you decide to ask for an appointment. Otherwise, you will be overcharged.

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Understanding LTC Insurance Company Rating

Thursday, May 14th, 2009

Companies are like people, and just like people, they can fall on financial hard times and suffer through bankruptcy. This is especially true for long-term care (LTC) insurance companies, who have to deal with an expensive and complex insurance system. As a result, some companies end up going into bankruptcy because they are unable to afford to pay out benefits due to a variety of factors. This means it is very important for individuals to look at LTC insurance company ratings so that they are not left with nothing to show for the premium payments.

One of the best ways to determine if a company is going to head into financial difficulties is by looking at LTC insurance company ratings, which come from several companies including Standard & Poor’s, Moody’s and A.M. Best. The rating system was created to ensure that insurance companies were financially sound when issuing a policy.

Currently, Standard & Poor’s publishes a rating on thousands of insurance companies, while A.M. Best publishes 50 different reports about insurance companies and has been in business for over 100 years, as well as being one of the largest insurance rating companies in the world.

The credit ratings provided by these evaluation companies can give a clear indication about the risk potential of putting your money into a company, however this is not an endorsement of that company, as many individuals think.

The rating system will differ, but the results are generally the same. While Standard & Poor’s best rating is AAA, Moody’s is Aaa and Best’s is A . This signifies an excellent record of financial stability and an ability to meet the demands of policyholders.

Low ratings are generally universal in how the insurance evaluators rate them, with F being the lowest of the low. You will not want to be a part of a company with an F rating because they are nearly bankrupt, or they have begun bankruptcy proceedings. In terms of companies with a C or a D rating, you should avoid taking out long-term care insurance with them because their LTC insurance company rating is not that great. Try and only go through companies with a high rating. Remember, it is your money and you don’t want to pay into something you won’t be able to benefit from later on down the road.

Conclusion When you pay money into a policy that will keep your head, as well as your family’s heads, above financial water when you are in need of long-term care, you want to make sure that the company you pay to is going to be around in 30, 20 or 10 years.

You should just ask for help from an insurance representative who specializes in long term care insurance to answer any questions.

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What you should know about Long Term Care Insurance

Thursday, May 14th, 2009

If you want to get a long term care insurance quote, it is essential that you know some of the factors involved. This particular article will give you six essential factors to take into consideration. If you want an ltci quote, there is so much information you will want to know about so that you can make an informed decision. This information is based upon factors such as what type of benefits you want to receive when using your policy.

A long term care insurance quote is contingent upon many factors and following are some of the points to consider. Your age and what type of benefits will cause your quote to vary.

The types of benefits you receive will help determine your cost of long-term care. These types of benefits can include whether you will receive in-home services, care at a nursing home or from services based in your community.

The cost of your ltci quote is contingent upon age so the younger you are when you purchase ltci will cause your premium to be lower.

Different costs for quotes can be based upon what company you request a quote for. You should ask your employer if they offer ltci.

Your quote can be contingent upon how you want benefits to be paid out. Some policies allow you to spend a certain maximum in whatever way you want while others offer a maximum based upon a daily, weekly, or monthly time frame.

You have the option to choose when you are able to start using benefits and this will cause a change in your insurance quote.

You will want to think about what kind of daily benefits you will receive. Your quote will be higher when you want higher daily benefits.

This article should have opened your eyes to a greater degree to what to expect when receiving a long term care insurance quote. You want to have as much information out and on the table when talking about this because it is important to know what to expect with your policy.

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